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Navy to slash medical billets

The Navy says it will eliminate more than 3,000 corpsman billets and about 600 physician, dentist, nurse and other medical officer billets between now and 2012 in an effort to focus the medical corps on supporting military operations.

Those numbers do not include the nearly 1,400 corpsman and 700 medical officer billets that have been slashed during the past two years in accordance with a directive to remove military personnel from fields at naval hospitals, such as pediatrics and geriatrics, that are used primarily for treating dependents and retirees. Those positions are to be filled by civilians.

That means that between 2005 and 2012, the Navy will have lost roughly 20 percent of its corpsman billets and significant percentages of several medical officer jobs:

• 28 percent of Dental Corps billets.

• 14 percent of Medical Service Corps billets, which include jobs for physical therapists, pharmacists and physician assistants.

• 6 percent of Medical Corps billets.

• 4 percent of Nurse Corps billets.

Cmdr. Larry Bateman, deputy director of personnel for the Navy’s Bureau of Medicine and Surgery, said corpsmen and medical officers in billets targeted for conversion will be allowed to move to an operational billet, either at their duty station or at another location.

“We are not going to kick anybody out or [reduction in force] anybody,” he said, adding that corpsmen and medical officers also won’t be required to change ratings or designators.

Billet cuts will be reconciled by attrition, according to bureau spokeswoman Christine Mahoney, but Navy personnel officials say Medical Corps accessions will remain about the same during the next five years.

Navy officials will fill most of the eliminated billets with federal civil service employees, Bateman said, or with contractors when civil servants cannot be hired, but he said an undetermined number of converted billets will remain unfilled because a subsequent study has found that they are not needed.

The Navy has 347,000 enlisted sailors and officers. By the end of next year, that number should fall to about 340,700. Navy officials say that number should continue to decrease in subsequent years but were unable to offer firm numbers.

Bateman refused to link the cuts to a Navy drawdown.

He insisted that eliminated billets would not result in decreased quality of care given to sailors, their dependents or retirees, pointing out that 85 percent of positions converted during 2005 and 2006 have been filled by civilian hires.

He said converting corpsman and medical officer billets would not affect sea/shore rotations for Medical Corps personnel because converted billets were unlikely to deploy even before they were converted.

But a Navy surgeon at Portsmouth Naval Hospital, Va., who declined to be identified in this story, said focusing on billets misses the point: If billets at naval hospitals dry up, corpsmen and medical officers would have less ability to rotate between hospital assignments and forward deployments.

“The question is whether deploying personnel will have any place to return to and provide medical care to active duty, retirees and dependents as they have been trained to do,” the surgeon said. “Most physicians don’t want to just go to Afghanistan. Most of us want a range of assignments.”

The surgeon speculated that a lack of hospital billets in the continental U.S. would lead to increasing overseas deployments. That could work against Navy efforts to recruit and retain corpsmen and medical officers, he said, because many see assignments at Navy hospitals, where they frequently work fewer hours than their civilian counterparts, as compensation for long deployments and military pay, which can lag civilian pay for doctors by hundreds of thousands of dollars per year and by smaller amounts for dentists, nurses and corpsmen.

“In the past, we have always exchanged quality of life at hospitals in the continental U.S. for the stresses of deployment medicine,” he said.

But Mahoney said Navy officials did not eliminate billets to increase deployment tempos for corpsmen and medical officers.

“That is not the intention,” she said. “That is not the case because you don’t want to run people out [of the Navy].”

Mahoney added that she could not predict what future deployment schedules will look like, but she said corpsmen and medical officers would continue to have stateside options after returning from overseas deployments.

The surgeon also questioned the methodology of studies that lead to the conclusion that there are too many billets. Although he acknowledged that some billets, such as those at hospitals that have closed, need to be cut, he said some billets might need to be spared.

The surgeon said Navy officials have determined billet needs by comparing Navy medical personnel with their civilian counterparts, without taking into account frequent absences because of physical fitness and military training, the need to train military nurses and the need to deploy.

“They want to compare our productivity to that of civilian doctors,” he said. “Well, give me the resources that civilian doctors have before you do that.

“Decisions have been made on billet structures based on civilian standards,” he said, arguing that such decisions will lead officials to cut too many billets and lead to overworked corpsmen and medical officers.

The surgeon said this will eventually lead to a shortage of medical personnel.

“You work overseas, with the Fleet Marine Force or on a ship. Those are your options,” the surgeon said, adding that most physicians, dentists and many senior nurses and corpsmen don’t want to spend so much time deployed. “It’s OK now, but in four to five years, you’re going to have a perfect storm in Navy medicine.”

Statistics seem to bear him out.

Although more than 90 percent of Navy physician and dentist billets are filled, the program that trains more than 70 percent of the Navy’s physicians and 80 percent of its dentists has signed up just more than half — 162 of 291 — of its recruiting target in 2005. However, Dental Corps community manager Cmdr. Kurt Houser said the Navy’s 53 percent retention rate for dentists during the past five years is within historical averages.

Care could improve because civilians normally stay in a position for a longer period than a sailor would, Bateman said, which can lead to greater care continuity; also, civilians would not be subject to frequent absences caused by deployments and military training.

Hospital corpsman billets will be filled by medical clerks, nursing assistants, practical nurses, secretaries and other titles, according to a statement released by the medical bureau. Medical officers will be replaced by equivalent board-certified civilians, Bateman said.

Conversions will also lead to a savings of about $20 million over a five-year period, Mahoney said.

Corpsmen will be replaced by civil service workers in grades GS-4 through GS-11, with salaries that will range from $22,000 to $60,000. Nurses will be replaced by civil servants in grades GS-9 through 12, with salaries ranging from $38,000 to $72,000; dentists, by civil servants in grades GS-13 and 14, with salaries ranging from $65,000 to $101,000; and physicians, by civil servants in grades GS-14 and 15, with salaries ranging from $77,000 to $119,000, according to information provided by BuMed and the U.S. Office of Personnel Management.